Isotretinoin (Accutane®)
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Side Effects

Isotretinoin is a vitamin A derivative called a retinoid that is taken orally and is approved only for severe acne. It is thought...

Isotretinoin is a vitamin A derivative called a retinoid that is taken orally and is approved only for severe acne. It is thought to clear acne primarily through its ability to permanently reduce skin oil (sebum) production.

Isotretinoin is available in capsule form and is usually taken twice a day. Your physician will prescribe an initial dose, and this dose may increase or decrease depending on the response to treatment and side effects.

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4
34.1%
3
15.3%
2
7.3%
1
6.2%

Used Isotretinoin (Accutane®)? Rate It:

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February 1, 2011

Pros:

- completely cleared cystic acne
- hair used to be overly oily - now it is manageable and stays clean all day!
- It's been 9 years since I took accutane and still no acne
- drastically improved self-esteem
- avoided the risks of long-term antibiotic treatment

Cons:

- dry, cracked lips
- finding an adequate dosage was difficult
- hassle dealing with pregnancy tests for females taking this drug

Many dermatologists will refer to accutane as a miracle drug and it most certainly is. My acne cleared entirely after 6 months of treatment and in the 9 years since I was treated with this medication I have had only mild, intermittent acne. I would describe my face in middle school and high school as looking like I had been stung by an entire hive of bees and now you would never know I had severe acne. Even with the new discoveries that have emerged regarding side effects, I would still highly recommend this treatment if you have tried all other options and they have all failed. While this drug can have some severe side effects for many patients, they are most commonly transient. There are many commercials on television that are produced by personal injury lawyers talking about the long term side effects of Accutane; the side effects they mention are horrible, but these occur in a relatively small subset of the patients who take this drug. Remember, patients taking antibiotics (tetracycline and doxycycline - and many others, but those are the ones most commonly used to treat propionobacterium acnes, the cause of your acne) for an extended period of time can have severe side effects 30 years down the road and beyond (those nasty side effects are not limited to Accutane, yet you hear about them much less frequently because they are a much more difficult target for personal injury lawsuits). If you are considering this drug, weigh the pros and cons (do the research), consider the severity of your acne (do not let your dermatologist push it on you if you do not have cystic acne), and consider how much your acne impacts your quality of life. If you decide to take accutane, monitor yourself closely, paying particular attention to your mood. Remember, you can always discontinue it if it becomes at all problematic.
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January 29, 2011

Pros:

It worked to clear up my skin. My acne is now pretty mild and completely manageable.

Cons:

As of writing this, it's been approximately 9 months since finishing up my course. I still have have bad sexual side effects that onset right after my course was over.

It wasn't worth it for me. My acne was leaving scars and I would still gladly take it back to get rid of what this drug has done to me.
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January 27, 2011

Pros:

Cleared cystic acne

Cons:

Makes you very moody.
Makes lips very dry.
Monthly blood test required for females.
Hard time getting insurance after taking this medicine.
SERIOUS birth defects possible if you get pregnant.

My dermatologist put me on this for about 5 months. He claimed it was "The miracle drug". I had some cystic acne, it cleared it up about 95%.After I went off the medicine I started a new job a few months later and worked for a company where I had to find my own health insurance, one of the questions on the application asks if you have taken this medicine.I said yes and Blue Cross declined me. Cigna approved me but is charging me 20% more because I took this medicine. Bottom line is there are far too many negative side effects that I was unaware of when I started taking this.My doctor did not inform me of all the side effects, he mainly focused on the fact that it causes birth defects, I was so caught up with trying to clear my skin I didnt research it enough. Now I see all the commercials about people that took Accutane and how it can seriously mess up your colon and other parts. I now use the Clinique Acne solutions 3 step and my skin is 99% clear without all the crazy side effects that Accutane brings. I would suggest trying all other options first and only using this as a last last last resort.
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January 25, 2011

Pros:

Clear Skin
Smooth Skin
Scars went away
Regained Confidence
Not having to worry about what my face will look like in the morning--VERY NICE!
My Insurance Covered it ALL! :D

Cons:

Dry, Cracked and Bleedy Lips
Dry Skin
Lethargic/Tired
Acne came back on my forehead and neck-back is still completely clear

Best decision I ever made. About to go on the second course with a higher dosage. If you want to feel confident or have that "what if" about your face, then give it a shot! :D
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January 23, 2011

Pros:

Clear Skin
Confidence
Less oily skin and hair

Cons:

No alcohol for the duration of treatment
Very dry skin and eczema
Slight hair loss (offset by use of moisturising treatments)

Going on Roaccutane is the best decision I have ever made in my entire life! I say that without any hesitation whatsoever. Yes there were bad times too during the course of my treatment but I honestly couldn't give a crap because I'm acne-free. I had a small initial outbreak that seemed huge at the time but at my 6 week visit I only had two pimples and they were the last pimples I have ever had. I was on Accutane for 5 months (was supposed to be 6) so that means I haven't had a zit in almost 4 months!!! I started off with 20mg and gradually worked up to 50mg so I reached a cumulative dosage of about 100mg. I am very aware that it is 20mg below the recommeded dosage but I hope that since I cleared so early and my acne was only moderate at it's worst but mostly mild that it will stay away. The reason I had to stop early is because of bad eczema on my cheeks that was unbearable for a few days that popped up every weekend (weird pattern) over Christmas. It also coincided with extremely cold weather here in Ireland so that was probably an exacerbating factor. My bottom line for Accutane is this - if you've tried everything else and your acne is really getting you down then go for it. I suffered for 5 years before I made the plunge and it was well worth it!
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January 20, 2011

Pros:

Less Oily skin, Helps get rid of acne

Cons:

Eyes Sensitivity increased, Have to moisturize hands and face alot.

Its been a little over a month and im just starting to see improvements in my skin. Another more or two and my skin will be looking great.
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January 18, 2011

Pros:

Embarrasing Acne is gone and I feel and look hott!

Cons:

Chapped Lips, and may have to go on a second treatment

It is worth it! I had chapped lips, and that's it. My acne has come back a little bit, but I did not take the prescription as I should have, so I am going to go back to the derm. and get back on it and take it like I should have. Even so my acne now can never compare to what I had. Also it is easily covered with make-up. My boyfriend before I knew him had terrible cystic acne, I met him while he was on the drug and I got to see him gradually get better. He also looks amazing. The bad side effects are rare, and I did all my research before I took the stuff. It is worth it if acne gets in the way of your social life or if you want to look better.
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January 15, 2011

Pros:

Acne GONE
Highly minimized redness

Cons:

some light sensitivity
dry hair and some hair loss
some dehydration
peeling lips

My acne started at 22, during a severly stressful period of my life. It was the cystic stuff that is deep, red and painful. For 15 months I tried various Rx and OTC topical agents, as well as monthly visitations to an esthetologist. Not only did none of these work, but the acne got worse and began spreading to my jawline and upper neck. After avoiding Accutane like the plague, I finally conceded to it out of desperation. Three months prior to use I also started Ortho-TriCyclin (sorry, men) which significantly reduced breakouts. For the Roaccutane, the Dr. prescribed me 10mg/day- a very low, safe dosage. Thanks to the OTC already clearing me up a lot, I didn't have any of the flaking associated with starting Accutane. I have been on it for 9 months, and today I take my last pill. The most inconvenient side affects are that I can barely drink alcohol or coffee b/c the added dehydration is very uncomfortable and ramps up headaches and the peeling/cracking of the lips. Also, about 5 months into it my hair became pretty dry to the point of some loss and to where I only wash it 2-3 times per week. But that should heal itself soon. For now, I have NO acne and it feels so good to be able to touch my own face and feel how smooth it is. Next step is to improve the scarring. Here are some tips that through my own experience I know for a fact help control acne: - Sugar is the DEVIL! Keep away from it. - Drink alcohol and caffeine sparingly. - Stay HYDRATED. Lack thereof always irritated my skin. Eats lots of fruits and vegetables, drink lots of water, use a good facial moisturizer. Coconut water is amazing for this. - Excersize. If you have any questions, e-mail me at bree_k28@[link removed].
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January 11, 2011
This is my 2nd time on accutane. I took it nearly 4 years ago. My cystic acne was at an all time high when I decided to go back onto it. Do the side effects suck? Yes, dry, flaky skin & cracked lips aren't fun. DRINK WATER! In the end, it is the only medication that took it away & kept it away. I've done all the other medications, trust me.
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January 11, 2011

Pros:

Clears up skin very quickly

Cons:

Dries out skin, lips, and eyes severely
Acne came back after a few months
Very serious side effects
Expensive even with healthcare

Even as a last resort I would not use accutane, it is better to live with the acne than what can arise from taking this drug. Depression is the one most people worry about when taking this, but there are others. Inflammatory Bowel Disease is one of the most severe problems as it is a life-long, debilitating disease. This product is far too risky to consider. After my acne returned from being gone for a few months I decided to try to fix it on my own and I have it under control. Cutting sugary and greasy foods out of my diet, and a baking soda mask twice a day to keep skin clean has almost completely cleared my skin, it takes more of a commitment than accutane but it is so much safer. Strongly oppose risking this medicne.
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Finding a Doctor

The right dermatologist can make a big difference to your patient experience and the success of your acne treatment plan. Here are the steps to find a dermatologist who is a good fit:

  1. Use the search feature on the American Academy of Dermatology website to look for board-certified dermatologists in your area, and filter the search results for doctors with a special interest in treating acne.
  2. Read online patient reviews of any dermatologists you are considering and ask people you know whether they have any experience with these dermatologists.
  3. Do your research and go to your first appointment with questions prepared.
  4. Listen to what your gut feeling tells you once you see a dermatologist in person. If you are not completely comfortable, try a different dermatologist.
Find a Doctor Using The American Acacemy of Dermatology Website

Finding a Doctor

Only a select few plastic surgeons specialize in acne scar revision surgery. Be certain to find a provider who specializes in acne scar repair and who is passionate and experienced in this area.

Be sure to:

  • Look at before and after photos, the more the better, especially patients with similar scarring to your own.
  • Be realistic about results. Look for improvement, not a cure.

Questions to ask a potential scar revision specialist:

  • Are you board certified? Be certain that they are board certified.
  • How long have you been performing these procedures? Normally, the more experience the better, however, some younger surgeons may be more on top of the latest procedures.
  • Can I speak to some of your other patients? Ask for references for several patients who had similar scarring and speak to them about the process and their satisfaction with results.

Red flags:

  • Their story changes: As you discuss different treatment options, if they tend to change their mind easily, or agree with whatever you say, consider this a red flag. A confident, experienced surgeon will possess strong, unwavering opinions.
  • Your gut tells you "no": Trust your gut. If you just don't feel that the doctor is the right fit, trust that and move on. On the other hand, if you feel they are the perfect specialist for you, trust that feeling.
Find a Doctor Using the American Society of Plastic Surgeons Website